Gut-Skin axis and healthy skin: a systematic review

Abstract

Introduction: The skin has a multifactorial aging process, both by intrinsic and extrinsic predictors. Skin diseases contributed almost 2.0% to the global burden of 308 diseases and injuries in recent years. The role of the gut microbiota (GM) in human aging is important. GM directly affects aging through the gastrointestinal system. The microbial impact on the skin is still not fully understood. Objective:  The present study analyzed the major scientific evidence on the relationship between gut microbiota and the skin, emphasizing the importance of intestinal health for aesthetically healthy skin. Methods: The systematic review rules of the PRISMA Platform were followed. The research was carried out from February to May 2023 in Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 137 articles were found. A total of 47 articles were fully evaluated and 27 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 30 studies at high risk of bias and 13 studies that did not meet the GRADE. It was concluded that current scientific evidence reveals the existence of an important Skin-GM axis, highlighting the management of dermatoses through probiotics and prebiotics, as well as lifestyle changes. To establish aesthetically healthy skin, it is imperative to manipulate the gut microbiota to achieve balance. Thus, treatments that elevate or repair a bowel are essential as adjunctive therapy in the management of inflammatory skin diseases and may contribute to the effectiveness of standard dermal therapy.